Roby Brock: Welcome to this edition of the Northwest Arkansas Business Journal Report. I'm your host, Roby Brock.
Well, health care policy in Arkansas and across the nation is certainly a mystery to some. We're seeing rising health insurance rates. At the same time, there's a lot of questions about what's happening at the federal level and how it could impact the state. I sat down with Craig Wilson, the new CEO of the Arkansas Center for Health Improvement, for a conversation. He's our guest on today's Northwest Arkansas Business Journal Report.
Joining me now, Craig Wilson. He is the president and CEO of the Arkansas Center for Health Improvement. Good to see you.
Craig Wilson: Good to see you.
Brock: Congratulations.
Wilson: Thank you very much.
Brock: On removing interim from your title there. So, for people who are not deeply versed in what ACHI does, explain what the Arkansas Center for Health Improvement does.
Wilson: At our core, we're a health policy and analytics shop. We've been around for more than 25 years now. I've been with the organization for more than half of its life. So I'm very familiar with how the organization operates. And we translate data into information for policymakers to make good decisions.
Brock: You guys are at the center of a lot of health care debates at the state capitol and in public affairs there. What might you do differently with the organization? How are you going to lead this organization differently than your predecessor?
Wilson: Well, we're going to have a little bit of a different style. I have, of course, a different style. And I come from a legal background, so that's a little bit of a difference. But I think really the dynamics of the organization are not owned by the leader. I don't think—we kind of respond nimbly to what's in the environment. And really in the health care environment, about every three or four years everything changes. There's something disruptive. And so we'll do our best to be responsive to what's in the environment.
I think one of the things that I really want to do is establish some research collaboratives, cross-disciplinary, in the education space a little bit. We're going to move a little bit into doing something that we can uniquely do in the health care space. One of the things that I think has been missing is a focus on supplemental coverage like dental coverage and vision coverage. We forget that those two things are part of the body as well. And I think we're uniquely positioned to be able to make some advancements in that space from a research and analytics standpoint.
Brock: You mentioned that health care changes every three to four years with something pretty dramatic. And we're in the midst of that right now, as a matter of fact. Let's talk about two different issues starting first with this: insurance premium subsidies through the Affordable Care Act exchanges. Does not look like at this point that a deal is going to get struck. What happens when a deal does not get struck?
Wilson: Yeah. You know, I always use the example of an individual who's just above the income level for coverage through Medicaid. And that's roughly about $25,000 annually for an individual. So for that individual, their coverage might cost them in the $13 to $15 range now. Without the enhanced tax credits, that's going to look like a huge leap, closer to $100 for them on a monthly basis. And for folks living at that income level, those are hard decisions about whether to continue that coverage.
Brock: So the possibility exists they don't get coverage. They drop out of the pool of insurance that causes everybody else…
Wilson: Correct. Yeah. And those are the people who are going to forego coverage—your healthier individuals—because there's not enough risk for them to purchase coverage.
Brock: Or they do have risk. They're going to walk into an emergency room, which is going to jack up prices.
Wilson: And so the pool that's left are the older, sicker populations. And that results in what's called a death spiral. And it just continually gets older and sicker.
Brock: We'll watch that debate. We'll see. And if you guys put anything out on that, be sure to send it my way.
The other thing that I think is pretty major here in Arkansas—and there are some components to this—is this rural health care transformation grant money. This is part of the One Big Beautiful Bill. There's, I think, $50 billion over about a two-year period that's going to get disbursed to the states. Arkansas anticipates it could get as much as $500 million to $1 billion through all of this. What do you think is realistic in terms of expectations on this?
Wilson: You know, it will not ultimately cover some of the reductions in funding that we've seen through the budget bill federally. I think what the budget bill really represents is a huge financial shift in responsibility from the federal government to the states and localities. So realistically, you're going to see a lot of variability in how states approach these funds and whether they're willing and able to complement those funds with state and local funds.
You know, the Rural Health Association, of which I'm a founding board member as well, and the Arkansas Center for Health Improvement has endorsed as well some principles that the Rural Health Association here in Arkansas put out. And I think it's really important that our rural providers are working collaboratively and regionally. I think that's going to be important. And the way that we go about divvying out—divvying up these funds—that we do it in a very transparent and strategic fashion.
Brock: Some of this money, I think, from policymakers I've talked to in the governor's office, they want to see some money put into workforce—not just your health care workforce, but also your doctor workforce with medical residency slots—and telehealth, two big areas there. Talk a little bit about both of those areas and what the needs are that you see.
Wilson: Yeah. We've done a lot of workforce analysis, primarily in the physician space. And we still need—we're still lacking in supply. There's a lot of maldistribution in the state. If you look at it on a statewide basis, it looks pretty good. But if you look in certain pockets, the supply is just not there in both primary care and specialty care.
One of the things that I think we really need to think about is establishing a standardized and modernized way of collecting health care professional licensure information so that we can really, on the front end, establish a baseline of where we are now and what we can do after the five years of these funds are dispersed.
Brock: Last question for you. What do you think that we're not focusing on in terms of health care that—and maybe it was in this application—but it has not garnered as much in terms of the headlines?
Wilson: Yeah. I think with any funding disbursement of this magnitude, you're going to have a lot of entities out of the state who are going to try to come into the state and may have good intentions but may have bad intentions. We've seen some of our rural hospitals that have been subject to some private equity investment that has turned out not so good. So making sure that the vendors and the investors who are coming in to do some of the projects that are going to be funded are vetted and really have good intentions for the people of the state of Arkansas is going to be important.
Brock: That's Craig Wilson, the new CEO of the Arkansas Center for Health Improvement. You can catch our full interview at nwabusinessjournal.com. That's all for this edition of the Northwest Arkansas Business Journal Report. I'm Roby Brock. We'll see you next time.
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